Heart attack ends obese woman's fight for life

841-pound woman who sought a better life dies

Published 6:30 am, Tuesday, March 6, 2007

Renee Williams' surgeon said she was "doing excellent" after gastric bypass.

Renee Williams' surgeon said she was "doing excellent" after gastric bypass.

Photo: Nick De La Torre, CHRONICLE

Heart attack ends obese woman's fight for life

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The 841-pound Austin woman thought to be the largest ever to undergo gastric bypass surgery has died of a massive heart attack at a Houston hospital.

Renee Williams, 29, was progressing well in the week and a half after undergoing the increasingly popular solution to morbid obesity, officials at Houston's Renaissance Hospital said. But she experienced chest pains Sunday that culminated in a fatal heart attack in the evening.

"It came unexpectedly," said Dr. Younan Nowzaradan, her surgeon at Renaissance. "She was doing excellent the end of last week and could have been released then. But, with or without the surgery, she was at risk for a heart attack."

Nowzaradan said he didn't think the surgery, known to be risky in patients of Williams' size, was a triggering event for the heart attack. He cited the lack of complications and how well she was doing more than a week and a half after the surgery.

There is no plan for an autopsy at the moment, though Williams' fiance said Monday he planned to push for one.

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The fiance, Jayson Clover, said he wants to determine for certain what killed Williams because "something wasn't right Sunday" when he was with her. Williams' mother said no autopsy was necessary because her daughter knew she was at risk, hospital officials said.

Williams had the surgery Feb. 20, a week after entering Renaissance at 851 pounds. Overweight since she was a child — she weighed 299 pounds in seventh grade — Williams had said she had searched for a surgeon for 1 1/2 years before Nowzaradan agreed to take her case. More than a dozen doctors turned her down, either because of the procedure's risks or the fact she was on Medicaid at the time, she had said.

The surgery, once frowned on by mainstream doctors, has soared in popularity lately, with more than 140,000 expected to be performed in 2007. It makes the stomach smaller and bypasses part of the small intestine, resulting in a patient who feels full more quickly, has less of an appetite and absorbs fewer calories.

It typically is performed on people with a body mass index, or BMI, between 35 and 60. The obesity classification begins at 30. In those cases, there is a small risk — one in every 100 or 200 patients dies.

It is significantly riskier in patients the size of Williams, who had a BMI of 137.5.

"I'd say the risk is at least five or six times greater in patients that size," said Dr. Garth Davis, medical director of The Methodist Hospital's weight-loss surgery program. "But those patients are going to die within five years anyway — they're ticking time bombs."

Davis, who has performed the procedure on a 750-pound man now down to 375 pounds, said a fatal post-operative complication that can occur are blood clots that travel to the heart. He said they're a risk of the surgery because the patient is so immobile thereafter.

But Nowzaradan, who has performed the surgery on four other people weighing more than 600 pounds (all still alive), said the team prevented that by putting in a filter — a net in the main vein that catches such clots before they can reach the heart. He said the cause of the heart attack appeared to be simply that her weight was too much for her heart.

Williams had appeared to be doing so well last Thursday, nine days after the surgery, that Renaissance planned to release her Sunday. They changed that plan Friday because doctors decided to surgically remove infected skin masses that made it difficult for Williams to switch sides in bed. That surgery was scheduled for next Tuesday.

Hit by drunken driver

Williams gained more than 400 pounds after she was hit by a drunken driver while driving in Austin in 2003. The accident, for which she won a $1.5 million legal settlement, partially crushed one of her legs and left her bedridden.

Clover, who'd planned to wed Williams on Valentine's Day 2008, said Williams knew "there were no guarantees," but thought the surgery was worth the risk because she wanted to be a mother to her two daughters. He said her death was hard to take because she was doing so well after the surgery.

"She had such a spirit, she'd make your heart melt," Clover said from Austin. "She went through a lot in her life, but she was never bitter. Even this surgery she used not just for herself but to get a message out, to give people a greater awareness of obesity."

Clover spoke Monday after visiting Williams' daughters — Mareena, 13, and Mariah, 8. He said they were taking their mother's death "as best as they can."

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A memorial service is planned for Thursday at Mission Funeral Home in Austin.